Care Home: Newlands Nursing & Residential Home

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What the care home does well Up to date information was given to the people who were thinking of moving into Newlands. The same information was available in the persons bedrooms for them to remind themselves of the homes policies and the complaints procedure. People were visited in their home or hospital by either the manager or the deputy manager and invited to spend a day at Newlands before they committed themselves to a longer stay. These visits were also used to complete a care needs assessment to make sure that the home could meet the needs of the people. The care plans we looked at during our visit had been completed with information that told the care staff about the persons health and social care needs and how these needs were to be met. Records in the care plans showed that they had been reviewed and changed as necessary to meet the persons changing needs. Doctors and other health care professionals visits were recorded with notes of the visit and any changes to treatments. The people we spoke with all said that they were happy with the care they received and that their privacy and dignity was respected. There were two activity organisers who between them worked over the seven days. This was so that there would be someone to give one to one support over the weekend especially to those people who did not have many visitors. Their was a large display in the entrance hall which showed the regular weekly activities and others which took place occasionally such as movement to music, entertainers, baking, manicures and hand massages. The home shared a mini-bus with other homes within the organisation. Newlands had the bus for about three days every six weeks. Recent trips out had been to Tatton Park in Cheshire and Etherow Park in Compstall. Representatives from the local Catholic, Anglican and Methodist churches visited regularly. Visitors were encouraged and could have a meal with their relative if they so wished. The dining tables looked nice with the spotlessly clean and well ironed white table clothes, coloured table runners and small vases of flowers. Complaints were taken seriously by the manager and were investigated within the timescale as stated within the complaints policy. Whenever necessary, action was taken to prevent the incident happening again and prevent the need for further complaints being made. Everyone had a Criminal Record Bureau, references and safeguarding adults register check to keep people safe from harm. Training was encouraged and the organisation would pay for or organise the staffs transport to access the training venues. All of the people we had contact with said that the training they were given was relevant to their role, helped them understand and meet individual needs and kept them up to date with new ways of working. What has improved since the last inspection? The home had recently opened the top floor `Beech Unit` as a fifteen bed assessment unit in conjunction with Stockport PCT. The staff of Newlands on the unit worked closely with the charge nurse from the PCT, the social worker and the consultants. We spoke with the unit manager, the social worker, manager of the home and two relatives who were visiting at the time of our inspection. All were pleased with the way in which it was working. A small number of people had decided to stay at Newlands and had moved into vacant beds in one of the other units. The activity organisers now had their own room which was just off the entrance hall; this made it very accessible to the residents and relatives so that they could discuss any ideas they may have with the organisers. The organisor we spoke with said that the introduction of a weekend organisor had been a success particularly with those people who did not have many visitors. For the past few months a stable staff group had been in place and there were no staff vacancies. The manager was working hard to maintain this improvement with training and supporting the staff team. There was a new manager in place who was committed to maintaining the improvements that had taken place over the past twelve months. Everyone we spoke with was pleased withe way in which she was managing the home and felt that she was approachable and supportive. The bathrooms which at the last inspection had tiles missing off the walls had all now been repaired. In the past the way in which records of dressings such as when they needed to be changed and progress was poor. This had been addressed and a new system put in place where by a permanent record was kept on the care plan and progress was monitored by the manager. What the care home could do better: We have made no formal recommendations in this report as the manager was aware of what further improvements could be made as was stated in the information we had received before the inspection. We also discussed where minor improvements in record keeping were necessary during our visit and these are included in the main body of the report. Key inspection report Care homes for older people Name: Address: Newlands Nursing & Residential Home 122 Heaton Moor Road Heaton Moor Stockport Cheshire SK4 4JY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jacqueline Kelly     Date: 2 4 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Newlands Nursing & Residential Home 122 Heaton Moor Road Heaton Moor Stockport Cheshire SK4 4JY 01614322236 01612823333 newlands@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Julie OSullivan Type of registration: Number of places registered: care home 72 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 72. The registered person may provide the following category/ies of service only: Care home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Date of last inspection Brief description of the care home Newlands Care Centre is owned by Southern Cross plc and provides care and accommodation for 72 people over the age of 45 years with physical disabilities and old age. The home is purpose built over four floors. Each floor has its own lounge, dining area and communal bathroom and toilets. All the rooms have their own en-suite Care Homes for Older People Page 4 of 28 Over 65 72 0 Brief description of the care home facilities. The home is situated in the Heaton Moor area of Stockport, which is approximately thirty minutes from Stockport town centre. Local amenities such as shops, pubs and GP surgeries, together with bus and train services are available. A copy of the homes last inspection report, service user guide, statement of purpose and newsletter were available from the main entrance area of the home. The current weekly fees range from £340.00 to £699.60. Further details regarding fees are available from the manager. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms we and us were used. We last inspected this service on the 26 May 2009 when we awarded an adequate quality rating. This was a key inspection and we spent a total of ten hours at the home. The manager did not know we were going to visit when we arrived on the first day however she was aware we would be visiting again the next day. Before this key inspection we asked the manager of the home to complete an Annual Care Homes for Older People Page 6 of 28 Quality Assurance Assessment (AQAA) to tell us what they felt they did well, what they needed to do better and to give us current information as to employment of staff and training provided over the past twelve months. The form had been completed honestly and it showed us the manager saw the service being provided the same way as we did. During the inspection we looked at the care files and care plans of four people who used the service and the personnel and training records of the care staff. We also looked at other documents such as the complaints record, menus and medication records. We talked to the people who used the service that were sitting in the lounge on the lower ground floor, another person in private in her bedroom. We talked to four sets of relatives and a social worker all of whom were visiting the home on the day we visited and to two people by telephone after the inspection took place. We also talked with the manager, deputy manager, unit manager, domestic assistant, activities organiser, receptionist, chef and kitchen assistant. Twenty (ten service user and ten staff) questionnaires were sent out to the home for the manager to distribute. We had returned to us four service user surveys and five staff. The information we received was mainly positive from both the staff and the people who used the service. All of the surveys for the people who used the service had been completed by relatives. Comments we received from the surveys completed by relatives on behalf of the people who lived at the home to the question what does the home do well were as follows; support my wife; mum always looks clean and tidy, laundry is well managed and clothes are clean, good food menu, mums personal hygiene is maintained well by the staff; staff very friendly and always approachable; we have always felt very comfortable here, and we have been pleased with the care, at first there was quite a lot of staff changes but that seems to have settled now. The staff said to the same questions what does the home do well the following; we are a caring staff, we all work to our best ability, the food is very good, our chef does her up most help everyones needs, also activities are very well organized, all in all the home is run as well as expected; all the staff are friendly and accommodating, they do their job well, hardworking and can trust them; the home provides a clean and safe environment for all residents, activities are provided to stimulate residents as much as possible, which can be quite difficult as residents health needs change, provides regular up to date training for all staff from domestic staff to RGNs; getting good feedback from familys, and suggestions to deliver better care; my personal opinion about Newlands in the last 12 months its been a pleasure to work for and with, I hope this continues. To the question what could the home do better we received the following from both relatives and care workers; there should be some decoration of the lower ground floor area and new carpet leading down to it, this spoils an otherwise beautiful home, one of the cleanest I have visited out of twenty-one places; could smell a bit fresher; I suggest that the home should improve on the number of cleaning staff to make the surroundings more presentable and clean. We did also receive two comments about the food not being as good as it could be and there were sometimes staff shortages which meant that people had to wait longer to be seen to. Both of these comments were discussed with the manager at the time of Care Homes for Older People Page 7 of 28 our visit. Explanations were provided to us which showed that they were being taken seriously and being dealt with through the oranisations complaints procedures. Over the past twelve months there had been fifteen complaints recorded none of which had been made directly to us. All but one which was still ongoing had been investigated and resolved to the satisfaction of the complainants. There had been three safeguarding adult referrals however only one had been investigated under safeguarding procedures. All had been concluded to the satisfaction of everyone concerned. Care Homes for Older People Page 8 of 28 What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 9 of 28 The home had recently opened the top floor Beech Unit as a fifteen bed assessment unit in conjunction with Stockport PCT. The staff of Newlands on the unit worked closely with the charge nurse from the PCT, the social worker and the consultants. We spoke with the unit manager, the social worker, manager of the home and two relatives who were visiting at the time of our inspection. All were pleased with the way in which it was working. A small number of people had decided to stay at Newlands and had moved into vacant beds in one of the other units. The activity organisers now had their own room which was just off the entrance hall; this made it very accessible to the residents and relatives so that they could discuss any ideas they may have with the organisers. The organisor we spoke with said that the introduction of a weekend organisor had been a success particularly with those people who did not have many visitors. For the past few months a stable staff group had been in place and there were no staff vacancies. The manager was working hard to maintain this improvement with training and supporting the staff team. There was a new manager in place who was committed to maintaining the improvements that had taken place over the past twelve months. Everyone we spoke with was pleased withe way in which she was managing the home and felt that she was approachable and supportive. The bathrooms which at the last inspection had tiles missing off the walls had all now been repaired. In the past the way in which records of dressings such as when they needed to be changed and progress was poor. This had been addressed and a new system put in place where by a permanent record was kept on the care plan and progress was monitored by the manager. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 10 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are admission and assessment procedures in place to make sure the care needs of the people are met. Evidence: All the rooms had a copy of the statement of purpose and the service user guide. Both documents had been updated with the recent changes to the management structure including the names of managers. Addresses and telephone numbers of relevant agencies such as the Care Quality Commission and Health Authority were also included. The address for Stockport Social Services was incorrect and the manager was informed of this. The manager immediately obtained the correct address and instructed the administration staff to amend the documents. By the end of our visit all had been corrected. The four service user surveys we had returned said they received enough information to help them make a decision about the home. The five staff surveys we received said that they had up to date information to help them care for the people who lived at Newlands. Care Homes for Older People Page 12 of 28 Evidence: Everyone who was referred to the home by social services had a care plan which had been written by the social worker. Once this had been received either the manager or the deputy manager visited the person at home or in hospital so that they could pass on information to the person what the home was like and at the same time see if the home could meet the persons needs. People were also offered the chance to visit the home for a day and have a meal. From the social services plan and the visit to the person the homes own care needs assessment form was completed. This formed the care plan and gave an overall picture of the persons health, medication and social activity. The manager said that whenever possible people now had written confirmation of the homes ability to meet their needs before they were admitted to the home. Whilst the home was not offering intermediate care they had recently opened a dedicated unit (Beech Unit on the top floor) to continuing assessment in conjunction with Stockport PCT. The people who were admitted to this unit were assessed by the liaison nurse from the PCT who then discussed the persons needs with the manager. The staff were in close contact with the Charge Nurse from the PCT, the hospital social worker and GP. People stayed on the unit for six weeks whilst they were assessed. Some people had become permanent at Newlands and had moved down to one of the other three floors. Others had been discharged either home or to other care homes. Care Homes for Older People Page 13 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Newlands have their needs met and their care is provided in a way that respects their privacy and dignity. Evidence: Care files for four people were looked at during our visit. They all followed the companys set format and used their documentation. The files were set in sections which covered daily living, risk assessments, dependency levels, moving and handling, nutrition, urinary continence, bowel elimination and falls risk assessments. The daily recordings were up to date however the information tended to be the same and repetitive. This was brought to the attention of the manager to see if improvements could be made so that the recording was more personal to each person. Everyone was given a key worker and a named nurse or lead person on admission. This was so that people had someone they could go to with any queries and who was responsible for settling the person into the home. The name of the key worker and nurse was attached to the back of the bedroom door to remind people who they were. The manager was hoping to introduce a photograph to sit alongside the name of the key worker and named nurse. Care Homes for Older People Page 14 of 28 Evidence: Peoples health needs were met through the GP who attended the home regularly and had a twice weekly surgery . However people could keep their own GP if they wanted to and the GP would visit. The Tissue Viability Nurse was contacted as and when necessary to advise on treatment of pressure ulcers which were usually people who had been admitted from elsewhere. No one had developed pressure sores whilst they had been living at Newlands. All the necessary equipment such as pressure relieving mattress or cushion was available as required. There had been problems in the past regarding the recording of when dressings needed changing and the progress of the wound. This had now been changed and a permanent record was now kept in the care plan. Photographs were taken each week and were given to the manager for her to monitor. Optician, chiropodist (who visited monthly) and dentist visited the home either on a regular basis or as needed dependent on the person. The manager said that other agencies such as occupational therapist, dieticians and physiotherapists also attended upon referral. There had been concerns in the past about medication; how it was ordered and how it was stored. This had on the whole been rectified. There had been one medication error which had been dealt with by the manager and the member of staff was put forward for re-training. The pharmacist from the Health Authority visited the home regularly to make sure that medication was being administered correctly. At their last visit just prior to our inspection they had not found any concerns. For those people who wished to manage their own medication they could do so after a full risk assessment had taken place. Lockable storage was provided and a monthly review was done to make sure that the person was still able to manage and there were no risks to their health and safety either of themselves or others. We asked people during our visit if their privacy and dignity were respected all agreed that it was. We saw that bedroom doors were kept shut unless the person requested otherwise and people knocked before entering. People looked clean and tidy and were dressed in their own clothes. Everyone had their own room with an en suite facility. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily life and social care needs of people are met by the staff team in a way that enables people to maintain their privacy and dignity. Evidence: Events and weekly activities were organised by two activity organisors who between them covered seven days. A very large display in the entrance hall which had on it all the activities that took place regularly and dates and times of entertainments that were planned. A newsletter was on the table in the centre of the entrance area together with photographs of parties that had taken place. The organisers now had their own room which was easliy accessible for people to talk with them if they wished. Three of the four people who returned the surveys said that they always had activities that they could take part in (one person said that this question was not applicable). We talked to one of the organisers who was pleased with the home and said that it had improved incredibly over the past twelve months. They said that the company had now provided a small budget for activities. They also told us that they discussed with the nurses each week any matters arising about the people the were working with. Care Homes for Older People Page 16 of 28 Evidence: Activities that took place were; concerts, birthday parties, movement to music, coffee mornings, manicures and hand massages. At weekends there was more one to one support especially for those people who did not have many visitors. The home had access to a mini-bus which they had for about three days every six to eight weeks. They had recently been trips to Tatton Park and Etherow Park. Representatives from the local Catholic, Anglican and Methodist churches visited regularly. Visitors were encouraged; we saw and spoke with six relatives during our time at the home all of whom visited a number of times a week with some visiting every day. People could have a meal at the home if they wished and on Mothers day it was open house to everyone. We were told by the staff that two families came and had a meal with their relative. None of the people we spoke with, which included relatives and people who lived at Newlands, had any complaints about the food indeed two people said that it was excellent. Of the four surveys we had returned to us one said always and 3 said usually that they liked the meals at the home. However the home had recently received a complaint that included comments about a recent tea time meal. This was being investigated by the manager. Another relative said that the chef had tried different foods to try and tempt the persons appetite. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are protected by the complaints and safeguarding procedures, which were understood by staff. Evidence: Both the statement of purpose and service user guide had a complaints procedure. Both these documents were placed in each persons bedroom with further copies placed on the table in the main entrance. The four surveys we had returned to us all said that they knew how to make a formal complaint and all knew who they could talk to informally. We looked at the complaints file which contained a record of complaints made and the responses and action taken by the managers of the service. At the time of the inspection a formal written complaint had been made to the manager which was being investigated and a response would be made to the complainants. The manager was to meet with the area manager to discuss the matters raised. After this meeting the complainants would be contacted. We have asked the manager to keep us informed of the outcome. There had been three safeguarding referrals however only one was investigated under safeguarding procedures and was concluded to the satisfaction of everyone concerned. The two other incidents were investigated internally and action taken such as retraining and specialist equipment was obtained. Care Homes for Older People Page 18 of 28 Evidence: Everyone had received training in safeguarding adults as part of their induction. Training was ongoing and would be offered again under the refresher programme as needed. Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS) training had not yet taken place. The manager said that there were plans for this to be provided by the in house training department. All new staff had a Safeguarding of Vulnerable Adults (SOVA) check before starting work and a Criminal Record Bureau (CRB) check. This was to make sure as far as possible that unsuitable people were not employed at the home. We asked a senior member of the staff team what they would do if they saw abuse taking place. Their answer was in line with safeguarding procedures which was to speak with the person and report it immediately to the manager. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a suitably adapted, clean, comfortable and pleasant home. Evidence: Newlands is located in the Heaton Moor area of Stockport and is close to shops, pubs, restaurants, churches, banks and chemists. The home was purpose built some fifteen years ago with a majority of single rooms which have an en-suite facilities. Many of the bathrooms at the last inspection had tiles missing from the walls; these had all been repaired. The floor covering however in some of the bathrooms, although looking cleaner, would benefit from replacement. The bedrooms are over four floors with each floor having a lounge and dining room. The home is spacious, furnished to a reasonable standard and was free from any unpleasant odours. The dining rooms looked good with all the tables having well ironed, clean white table cloths with a coloured runner and a small vase of flowers. People were encouraged to bring their own belongings as could be fitted into their room. Bedrooms were re-decorated when they became vacant and other areas were on a rolling programme. Two maintenance workers were employed one of whom also tended the gardens. Care Homes for Older People Page 20 of 28 Evidence: There were laundry facilities which had two industrial washing machines and two dryers also two laundry assistants were employed. There were policies and procedures on the control of infection and forty-three of the staff had received training. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Newlands are supported by staff who have gone through a thorough recruitment process so that people are safe from possible harm or poor practice. Evidence: On the day that we visited the manager told us that there was a full compliment of staff and that there were no vacancies. She also told us that there had been a stable staff group for a number of months now which was an improvement from our previous visit in 2009. Other changes from the previous inspection had been the introduction of unit managers which the manager and one of the unit managers said was working well. The information we received also told us that in the past three months agency staff had been used for one week due to holidays and staff being re-deployed to the newly opened assessment unit on the top floor and new staff commencing. Information from relatives told us that on occasions there may be a shortage of staff which was usually due to someone unable to work at short notice. However we were told that the manager always tried to get a replacement as soon as possible but this could take some time. Domestic staff, a handyman, a Gardener and two laundry assistants were employed Care Homes for Older People Page 22 of 28 Evidence: by the home to keep it clean and maintained. There had been an improvement in the maintenance which had reflected on the overall appearance of the home. One person suggested in the surveys we received that there could be more domestic staff employed to keep the home clean and tidy. However we did not see any areas which we thought were not of a good standard of cleanliness. A minimum ratio of fifty percent trained members of care staff (excluding trained nurses) with a National Vocational Qualification (NVQ) level 2 or above should be in place. The home was just short of this figure however five people were currently working towards the qualification. A thorough recruitment process which consisted of the completion of an application form, interview, Criminal Record Bureau check, safeguarding adults check were all in place to make sure that as far as possible only suitable people were employed. All of these documents were in evidence when we looked at the personnel and training files. It was suggested that the manager signed and dated the copies to confirm that the originals had been seen. The company had its own training manager who organised courses for the staff teams in a number of homes. If the staff had to travel to the training venue the company either paid for a taxi or one of the maintenance staff took them. The training records were looked at of the last two people to start at Newlands and two people who had worked at the home for a number of years. Training completed included, moving and handling, safe guarding adults, first aid, infection control. An induction procedure was in place which three people who completed a survey said covered everything very well and two said mostly. The induction consisted of a check list although there was some training that required the completion of a questionnaire to show that the person had understood what they had learned. It was discussed with the manage that a work book be introduced which required more written evidence from the care worker to show that they were aware of what was needed. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Newlands is well managed so that it is run in the best interest of the people who live there. Evidence: A new manager had been appointed since the previous inspection of 2009. She had many years of experience and had qualified as a Registered Mental Nurse in 1993. The manager also had a National Vocational Qualification level 3 in Management and had enrolled on the Registered Managers Award course. At the time of our visit she was in the process of registering with us as the registered manager of Newlands. The company had a number of ways in seeking peoples views and opinions which consisted of customer satisfaction surveys, dining room surveys, regular meetings with both staff and relatives. Unfortunately the relative meetings were not well attended and the manager had tried to have them at different times such as day and evening to fit in with peoples life styles. Reviews of the people who lived at the home took place after six weeks and thereon annually. However a review could be called at Care Homes for Older People Page 24 of 28 Evidence: any time it was felt necessary by either the home or family. Reviews included staff, social workers, relatives and the people who used the service. Reviews were recorded and kept on the persons care file. The staff of the home did not have any responsibility for peoples finances. Small amounts of money could be kept for day to day items such as hairdressing for which accounts were kept. We did not look at these during our visit. The companys auditor regularly visited to check all the accounts of the home. The manager made sure that the safety of the people who lived and worked at Newlands was a priority. Training took place in moving and handling (the deputy manager was a moving and handling trainer), fire safety, first aid and food hygiene. The company had a health and safety policy in place and the information we were given said that all the equipment had been serviced and checked as required under current legislation and manufactures recommendations. Risk assessments and accident records were completed as and when necessary to make sure that people were kept safe. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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